Investors representing more than €3.5 trillion of assets under management now support the AllTrials1 campaign and are asking the pharmaceutical companies they invest in to set out plans to ensure that clinical trials past, present and future are registered, and available results are reported.

The group of 85 pension funds and asset managers, based in Europe, the US and Australia, was assembled by BNP Paribas Investment Partners, working with AllTrials. It includes RobecoSAM, Aviva Investors, Boston Commons Asset Management, 65 UK local authority pension funds and the investment arm of Europe's largest medical research charity the Wellcome Trust. These investors are now starting meetings with pharmaceuticals companies, focusing their attention on the top 25 listed entities by market capitalization, to urge them to move towards clinical trial transparency.

Clinical trial results are being kept hidden

Clinical trials are at the core of drug development and essential to testing the effectiveness and safety of treatments. Yet the results from around half of past clinical trials have not been published2 and thousands have never even been registered. Trials with negative results are twice as likely to remain unreported as those with positive results2. So how medicines and treatments really compare with others is unknown. Doctors, patients, researchers and healthcare providers all over the world don't know which are the safest or most effective drugs.

This lack of transparency has other important effects too:

  • It betrays the trust of the hundreds of thousands of patients who volunteer for clinical trials, because their data are unused and unusable.
  • It means trials are unnecessarily duplicated (researchers can't see what has already been discovered) which wastes scarce research resources.
  • It wastes the opportunity to use the data already gathered, and which will never be gathered again, for further discovery and innovation.
  • Moreover, as every day passes information on what was done and what was found in these hidden trials is at risk of being lost forever as companies merge, and people move on.

The business case for trial transparency

The results of clinical trials determine whether or not a drug is marketed and strongly influence companies' valuations and stock prices. More importantly, analysts incorporate the results of Phase III trial into their company forecasts, as the data helps them assess the product's fit within its therapeutic market and predict future revenues.

Non publication of trial results has substantial financial and reputational implications for pharmaceutical companies, many of whom have been fined for keeping information from clinical trials hidden. The cumulative total of fines incurred by 21 pharmaceutical companies for marketing related issues between 2007 and mid-2015 was USD40 billion, of which 43% was directly related to minimizing side effects that were identified during the trials but not properly reported3.

This is why, conscious of the increasing risks associated with the lack of data transparency, BNP Paribas Investment Partners began working with AllTrials to ask its peers to encourage the companies they invest in to achieve greater transparency.

Síle Lane, Director of Campaigns, Sense About Science, co-founder of the AllTrials campaign: "For those who thought they could ignore AllTrials, those who thought they could ignore public calls for transparency, and those who thought no one was checking their compliance with the rules, here's a clear message from investors: Wake up."

Dr Ben Goldacre, author of Bad Pharma and co-founder of the AllTrials campaign: "This is a game changer. It sends a clear message to CEOs, boards, and other shareholders that they need to recognize that medicine and society have changed. Companies cannot expect any longer to routinely withhold the results of clinical trials on treatments taken by millions of people around the world. Pharma is increasingly split, with many showing leadership on transparency, and some stuck in the past. These investment firms are showing clearly that they will reward good data, and best practice. You don't need to hide data to make money in medicine: in fact, quite the opposite is true. Medicine is a knowledge economy. You make money from trust, and good data. That's the clear message from €3.5 trillion of investment funds."

Helena Viñes Fiestas, Head of Sustainability Research, BNP Paribas: "Alongside doctors and their patients, investors also risk being misled, given that an average of around 30% of pharmaceutical company valuations directly relates to the results of Phase III clinical trials. With company valuations and expected revenue streams a key component of the stock selection process, it is essential that companies publish complete and accurate information on trial results so that investment decisions can be fully informed."

Peter van der Werf, Engagement Specialist, RobecoSAM: "We are asking all the pharma companies we invest in to move towards transparency. By not being transparent, biopharmaceutical companies put their reputation at risk. We deem this to be a financially material factor and encourage all companies to gain credibility regarding their approach to clinical trial transparency by signing up to the AllTrials principles."

Nick Moakes, MD, Head of Equities, Wellcome Trust: "The Wellcome Trust has a long record of campaigning for wider access to research data, and we strongly support the AllTrials initiative both as a charity devoted to improving health and as an investor with holdings in the healthcare sector. We believe that more open trial data adds value not only to our charitable mission, but also to companies in which we invest by positioning them as responsible industry leaders. We also use our access as an investor to connect the management of these companies to scientific and policy colleagues who are expert in this issue, who can engage from a position of knowledge."